不同麻醉方法对腹腔镜胆囊切除术患者循环和应激的影响  

Effects of different anesthetic techniques on circulation and stress response in patients undergoing leparoscopic cholecystectomy

作　　者：王瑛[1] 史俊武[1] 

机构地区：[1]溧阳市人民医院麻醉科,213300

出　　处：《江苏医药》2008年第2期125-126,共2页Jiangsu Medical Journal

摘　　要：目的比较全麻复合硬膜外阻滞和单纯全麻用于腹腔镜胆囊切除术对患者术中循环和应激状态的影响。方法行腹腔镜胆囊切除术择期手术患者40例,随机分为全麻组(C组)和全麻复合硬膜外组(GE组),每组20例。观察患者术中的血流动力学,于诱导前(T1)、插管后5min(T2)、手术开始后30min(T3)及拔管后5min(T4)抽取外周静脉血测定皮质醇(Cor)及血糖(Glu)的浓度。结果GE组T2、T3和T4Cor、Glu水平以及血压、心率均与T1相仿(P>0.05),但明显低于C组(P<0.05)。C组T2、T3和T4Cor、Glu水平以及血压、心率均显著高于T1(P<0.05)。结论全麻复合硬膜外阻滞用于腹腔镜胆囊切除术,术中循环稳定、应激反应轻。Objective To observe the effects of general anesthesia and general anestheisia conbined with epidural blockade（GE） on BP, HR and stress response to surgery. Methods Fourty ASA class Ⅰ or Ⅱ patients undergoing leparoscopic cholecystectomy （LC） were randomly assigned into general anesthesia（group C） and group GE with 20 cases each. Systolic blood pressure（SBP）, diastolic blood pressure （DBP）, blood cortisol （Cor） and blood glucose （Glu） were recorded before anesthesia induction（T1） ,at 5 min after intubation（T2）, 30 min after skin incision（T3） and 5 min after extubation（T4）. Results SBP, DBP, HR, Cor and Glu at T2, T3 and T4 in group GE were not changed remarkably compared with those at T1（P〉0.05）, but were significantly lower than those in group C（P〈0.05）. SBP,DBP, HR, Cor and Glu at T2,T3 and T4 in group C were significantly higher than those at T1 （P〈0.05）. Conclusion Compared with general anesthesia, GE for LC can keep BP and HR stable with less stress responses.

关 键 词：全麻复合硬膜外阻滞 腹腔镜胆囊切除术 应激反应 皮质醇 血糖 

分 类 号：R614[医药卫生—麻醉学]